Economic evaluation of conditional cash transfer scheme for postponement of first pregnancy in newly married couples in Satara district of Maharashtra (India)

Background: Since 2007, Satara district is implementing a voluntary conditional cash transfer scheme named “Second Honeymoon Package” (SHP) for postponement of first pregnancy. This study was undertaken to evaluate it’s effectiveness in preventing pregnancies, utilizing the years for learning or betterment in jobs. Cost-effectiveness analysis was undertaken from government’s viewpoint and that from beneficiary’s viewpoint. Objectives: To perform the economic evaluation of second honeymoon package programme from the perspective of beneficiaries and that of Government of Maharashtra during the defined time horizon. To determine the targets to be achieved so as to make the programme cost- effective. Materials and Methods: This was an evaluation study of a community based interventional programme. This study employed quasi-experimental study design. Economic evaluation was conducted from the perspective of Government of Maharashtra and that of beneficiaries’. Costs and consequences SHP were evaluated in comparison with those of routine family welfare programme. Sensitivity analysis was done using Treeage Pro® version 2009 software. Results: Cost for participation in programme was Rs. 965888/268 person years of productivity. Cost of not participating in the Second honeymoon programme but availing routine family planning services was Rs. 298902/133 person years gained. Rankings analysis showed that no strategies were clearly dominated by any other. Extended dominance report indicates no strategies were eliminated by extended dominance. Incremental cost-effectiveness ratio was Rs.4920/person year of productivity. Conclusions: The SHP is cost effective at high success and productivity rates. The success rate of postponement of first pregnancy was 51.4%. Postponement of pregnancy by 2 years provides 45% chances of productive utilization of time.